With the snow we had in late April, it may be hard to believe, but warmer weather in Michigan is just around the corner! I’m sure we are all looking forward to putting away our heavy coats and snow boots, and enjoying some sunshine.

Those who already know me and the rest of our providers at IHA Dermatology may get a chuckle from that previous sentence, particularly the part about “enjoying sunshine,” given how often we stress to our patients the importance of protecting oneself from the sun and using sunscreen regularly.

As some of you may know, the month of May has been designated Skin Cancer Awareness Month, which makes it an ideal time to remind our family, friends, and colleagues to become educated about the importance of protecting our body’s largest organ, the skin.

To illustrate why this is such an important topic, I’ll share with you some facts and figures that are nicely summarized in websites for the American Academy of Dermatology and the Skin Cancer Foundation, where you can find even more information about this serious subject.

Did you know that skin cancer is by far the most commonly diagnosed cancer, with more than 3.5 million cases diagnosed in the U.S. each year? In fact, more new cases of skin cancer are diagnosed yearly than the combined incidences of lung, breast, colon, and prostate cancer.

Of particular concern, about 140,000 cases of melanoma, the most deadly form of skin cancer, will be diagnosed this year, and on average, one American dies from melanoma every hour. Unfortunately, the incidence of skin cancer is rising, particularly in younger people and in women, and melanoma is now the leading cause of cancer death in women ages 25 to 30. The good news is that most skin cancers are preventable and the vast majority can be cured relatively easily, especially if they are diagnosed and treated early.

That is why we recommend that everyone seek protection from the sun by wearing sunscreen with an SPF of 30 or more, and reapplying sunscreen at least every 2-3 hours. Staying shaded and wearing sun-protective clothing whenever possible is also very helpful. Tanning and using tanning beds are harmful, and if you are worried about cosmetics at all, be aware that tanning and excessive sun exposure ages your skin dramatically.

To aid in early detection of skin cancer, we also suggest that you become familiar with your own skin and check yourself about monthly for any spots, bumps, moles, or lesions that look different from the rest, or are changing in any concerning way, such as by bleeding, itching, not healing, or growing rapidly. For those with a lot of moles, you can use your handy cell phone cameras to take pictures and look at them monthly to see if any have changed.

In addition to performing self-skin examinations regularly, it is generally a good idea to have yearly full skin evaluations by your board-certified dermatologist or primary care physician.

If you are interested in having a skin cancer screening or would like to have a concerning lesion evaluated, our board-certified and experienced dermatologists at IHA Dermatology are always happy to help in any way that we can. Just call us at 734-667-DERM (3376) to schedule an appointment. On behalf of IHA and IHA Dermatology, we hope you have a warm, fun, and most importantly, healthy May and summer. Bring on the sunshine (and sunscreen)!

With the recent snow that blew through and the temperatures that are going to stay low over the next few days, many of us are still digging out our cars or way out of our driveways. Anyone can end up with frostbite or hypothermia, it’s important to know the risks of frostbite and hypothermia, especially for those that are at higher risk and are more susceptible to extremely cold weather. Some groups that be at higher risk include:

  • Very young children and our older senior population
  • Diabetic patients and other with conditions leading to poor circulation
  • Patients with heart conditions or those who take beta blockers

Don’t Ignore Shivering!

When you’re exposed to cold temperatures your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will use up your body’s energy, resulting in hypothermia. Some warning signs of hypothermia include:
  • Shivering
  • Exhaustion
  • Confusion
  • Trembling hands
  • Memory loss
  • Slurred Speech
  • Drowsiness

If you notice any of these signs, please seek immediate medical attention.

Frostbite is literally the freezing of body tissue; fingers, toes, ears and nose are the most vulnerable. Frostbite is caused by prolonged exposure to cold temperatures, or shorter exposure to extremely cold temperatures. The warning signs of frostbite are:

  • Red or pale skin
  • Prickling
  • numbness

Frostbite and hypothermia can be prevented; here are some tips to help keep you safe:

  • Limit the time you’re outside in cold, wet or windy weather
  • Stay well hydrated
  • Dress in several layers of loose, warm clothing
  • Wear a hat or headband that fully covers your ears
  • Wear mittens rather than gloves
  • Wear socks and liners that fit well and wick moisture
  • Keep moving

 

 

 

Reposted with permission; originally posted in the 2015 spring edition of Cardiac Advantage

Traditional treatment for severe aortic stenosis – a narrowing of the valve that allows blood to flow from the heart to the body- has been to open the chest, remove the fault valve and replace it with a new one.

Many patients are too sick or too frail to tolerate open-heart surgery. “For a long time, we had little to offer patients with severe aortic stenosis if they were unable to undergo open heart surgery because of their age and/or the severity of their medical condition,” said cardiothoracic surgeon Andrew Pruitt, MD, at St. Joseph Mercy Ann Arbor. “Now there is new hope. In August 2012, we began performing an exciting new procedure, transcatheter aortic valve replacement (TAVR), that is holding great promise for patients who formerly had no options.”

Some people with aortic stenosis have no symptoms at all, but for most patients symptoms include: shortness of breath, fatigue, difficulty exercising or performing other strenuous tasks, chest pain, lightheadedness or fainting.

“In its earlier stages, aortic stenosis can be treated with medication, but in more advanced form traditional surgery, and now, TAVR are the only options.”

How does TAVR work? The surgeon makes an incision in the groin (transfermorally) or through a space in the rib cage (transpically) and threads a catheter into the blood vessel to reach the aortic valve. A balloon on the end of the catheter is inflated forcing open the stiff leaflets of the damaged aortic valve. This leaves room to replace the original catheter with a second one. The second catheter not only has a balloon on the end, but also a compressed replacement valve. The replacement valve is made of cow heart tissue that is sewn onto an expandable stainless steel stent. The new valve is placed on the center of the disease valve and then expanded into proper position with the aid of the balloon. Physicians can choose replacement valves to fit a wide range of patient sizes.

A key advantage is that the procedure is performed on a beating heart and the patient does not have to put on a cardiopulmonary bypass machine, so it is far less stressful for the body. The transfemoral approach usually requires about three hours to complete; the transapical about 30 minutes less.

Developed in 2000 by a French cardiologist, TAVR was approved for use in the United States in 2011, slightly ahead of schedule when clinical trials proved remarkably successful.

However, TAVR is still relatively new and not without risk. “Currently, this approach is limited to patients who must meet very specific criteria,” said Dr. Pruitt. “TAVR brings with it its own set of side effects and has as slightly higher rate of certain complications than traditional, open-heart surgery. The FDA has only approved its use for patients with severe, symptomatic aortic stenosis who are felt to be inoperable, or at very high risk for traditional surgery by two independent cardiac surgeons.”

In addition, potential candidates must undergo a series of test to determine if they meet the physical and medical parameters to accept the device safely. “We very carefully have to weigh risks versus benefits, and for those patients who cannot tolerate open-heart surgery, TAVR can be a life saver,” said Dr. Pruitt. “TAVR not only extends patients’ lives, it can significantly improve their quality of life.”

Cardiologists and cardiac surgeons at St. Joe underwent intensive training to learn this new surgical procedure. Based on the high volume of surgeries conducted here, the expertise of our physicians and staff, and the collaborative multidisciplinary heart team that evaluates all potential cases, patients who qualify for TAVR can feel confident in the skill level and experience of their heart team.

“The message to prospective patients and their referring physicians is this: Don’t give up hope. Even for the frailest patients with extremely advanced conditions, we can offer solutions and relief,” said Dr. Pruitt. “In cases where TAVR is an option, it literally can mean the difference between life and death.”